Adult social care warning for eight areas of England

Eight local authorities in England have been told they must urgently improve their social care services for adults.

The Care Quality Commission found overall improvement, with 95% of councils in the top two categories.

But its annual report rated one in four care homes for the elderly as being adequate at best and found large variations in areas and providers.

Poole, Cornwall, Solihull, Surrey, South Tyneside, Southwark, Peterborough and Bromley are to get extra support.

But Annie Shepperd, a chief executive of one of those councils, Southwark, said the Care Quality Commission (CQC) had made a mistake in rating her authority.

COUNCIL CARE SERVICES 2009

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She said the CQC had judged them to be a low spending authority but the other regulator, the Audit Commission, had said they were a top quartile spending authority, "they can't both be right".

"Why have they refused to come and talk to me about this and why have they not given me the evidence when I've got mountains of contrary evidence that their findings are wrong."

The report covers independent providers of care services as well as an assessment of England's 148 local authorities.

It rated 95% of councils in the top two categories, which means they are performing well or excellently - and none was given the bottom "poor" rating.

'Raise the bar'

While the picture is of improvement, the commission said there are still too many vulnerable adults being failed by the system.

CARE QUALITY COMMISSION

The Care Quality Commission is the official regulator for health, social care and mental health

It only came into being in April 2009, bringing together the functions of three regulators - the Healthcare Commission, Commission for Social Care Inspection and Mental Health Act Commission

It is in charge of inspecting, rating and assessing NHS trusts, councils, private companies and charities involved in health and social care provision

Under new powers being phased in, it has the power to fine and close services that are failing and is demanding providers meet certain standards before they can even register with the regulator

And experts have suggested the top grades were achieved only because councils were providing care to fewer people.

More than 340,000 people in England receive care in their own home - a figure which has fallen by a fifth in the past eight years.

To cope with the demands they face, councils have been restricting who is eligible for free or subsidised care - social services is means-tested so that people with significant savings are excluded anyway.

The figures from the regulator showed seven in 10 councils only provide care to those with substantial needs - basically those who cannot do everyday tasks, such as washing, dressing and eating, without help.

It means there are thousands of people with so-called low or moderate needs who have been excluded from state support they would normally have been entitled to.

Despite the high ratings given to councils, the regulator recognised the problem.

It said it would be looking to "raise the bar" in the future and would pay particular attention to eligibility.

RATINGS ON THE RISE

95% of councils got an excellent or performing well grade - up from 87% last year

None got a poor rating - the fourth year in a row this has happened

Eight councils given an adequate grading were earmarked as a priority for improvement

More than three-quarters of private and voluntary sector providers also got an excellent or performing well grade

But one in six of the 24,000 providers were told they must improve

Care homes for the elderly were highlighted for their poor record of providing social contact and activities for residents

The CQC also urged councils to do more to drive up standards in the voluntary and private sector.

From next year, changes to the ratings system will give more weight to the views of those using care services and fines will be able to be levied against providers the regulator considers are not providing a good enough service.

Most care homes and an increasingly significant amount of home care is delivered by 24,000 alternative providers.

Ratings for those showed one in six were ranked as poor or adequate - and the CQC warned they were risking fines or deregistration next year when the new system comes in place.

Care homes for older people were highlighted in particular for their poor record on providing social contact and activities for residents.

Councils purchase about half of the services provided by these groups and the CQC said they should look to focus their spending on only the best providers where possible.

CQC chief executive Cynthia Bower said the improvements in council services should be recognised, although they could still do much better on issues such as dignity and offering people more choice.

'Dignified lives'

But she also warned she was "deeply concerned" the expected squeeze on public sector spending could lead to greater restrictions on access.

"We all know there are choppy waters ahead so the issue is how well the system responds to the situation.

"We plan to be particularly vigilant about this on behalf of people who use services."

Andrew Harrop, head of public policy for the newly-merged Age Concern and Help the Aged charity, said some care homes were clearly still "not up to scratch".

And on tightening eligibility criteria, he added: "Local councils continue to deny many older people the care they need to live dignified and independent lives."

But Councillor David Rogers, of the Local Government Association, said: "Councils deserve great credit for their continued good work."

Solihull Council said it was "utterly committed" to working to improve services, while a spokesperson for South Tyneside Council said: "We welcome this support to help us move forward with our modernisation of adult social care."

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